Murmurs & Lung Sounds Flashcards
things to consider when grading murmurs “SCRIPT”
Most important 2
Site Character Radiation Intensity Pitch Timing
Timing & severity
• Grade I
Lowest intensity, not audible
• Grade II
- soft, but heard in all positions
• Grade III
Moderate
• Grade IV
Moderate intensity, Thrill
• Grade V
- barely place stethoscope on chest & hear Thrill
• Grade VI
can hear a L/H/T w/stethoscope off pt
T/F: A thrill associated with a murmur represents significant turbulence and is always pathologic
True. yikes
T/F: For practical purposes, a diastolic murmur is never pathologic.
False. Diastolic murmurs are always pathologic
-Popping open of air-fluid levels as airways dilate with inspiration
Lung crackles/rales
-Pneumonia, atelectasis, pulmonary fibrosis, acute bronchitis, bronchiectasis, interstitial lung disease, pulmonary edema/CHF, COVID-19
Lung Crackles/Rales
-Asthma, COPD, anaphylaxis, foreign object, smoking, allergies, bronchitis, epiglottitis, CHF, drugs (ie: ASA), pneumonia, respiratory tract infection, vocal cord dysfunction
Wheeze
-May clear with coughing, gurgling or bubbling sounds usually during inhalation & exhalation
Rhonchi
-COPD (often chronic bronchitis), bronchiectasis, cystic fibrosis, viral URI, secretions in airway
Rhonchi
Pericardial friction rub
Pericarditis
Systolic Murmurs (6)
-Aortic stenosis, Pulmonic stenosis, mitral regurgitation, tricuspid regurgitation, mitral valve prolapse, HCM
Diastolic murmur (4)
Aortic regurgitation, pulmonic regurgitation, mitral stenosis, tricuspid stenosis
Continuous murmur (1)
PDA
-Usually on inhalation from narrowing in the airway (extrathoracic)
Stridor
-Croup, laryngomalacia
Stridor
The easy, not-scary murmur ID method (4 Steps)
Systolic or diastolic?
Where do you hear it best?
How loud is it, from I-VI?
(At IV and above, you can feel a lift/heave)
Order an echo, and it will tell you exactly the problem is 😊
